For the more than two-thirds of Americans who are overweight, artificial sweeteners may seem like a dream come true: sweet taste without the calories. However, in the most comprehensive review of artificial sweeteners to date, health experts have concluded that the weight loss benefits of these products may indeed be just a dream.

The sweet truth

When considering artificial sweeteners, keep in mind that many issues related to the American diet and food industry are highly politicized. Those who promote artificial sweeteners suggest these products are essential to weight loss efforts. Those in the natural health and organic food communities suggest artificial sweeteners are bad for health. In reality, the truth is somewhere in the middle: Artificial sweeteners are not necessary and effective for weight loss, nor will they ruin your health.

To arrive at this conclusion, researchers completed a comprehensive review of over 200 research papers and resources on artificial sweeteners. The review covers six artificial sweeteners that are approved for use in the US, Canada, and/or Europe: acesulfame-K (Sunett®), aspartame (NutraSweet®), cyclamate (Sugar Twin®), saccharin (Sweet’N Low®), sucralose (Splenda®), and neotame.

The reviewers were particularly interested in examining several popular theories about artificial sweeteners in relation to weight and appetite.

• Speculation: By providing a sweet taste without any calories, artificial sweeteners “confuse” the brain and body, leading to increased appetite and subsequent over-eating. Review finding: This effect does not occur when artificial sweeteners are used in the context of a typical American diet.

• Speculation: Diet soda increases the odds of developing metabolic syndrome, a condition defined by the presence of several risk factors for heart disease, diabetes, and stroke. Review finding: There is no clear association between artificial sweeteners and metabolic syndrome.

• Speculation: Replacing sugary snacks and drinks with artificially sweetened options will help dieters shed pounds or keep them off in the long run. Review finding: In order to lose weight, a comprehensive approach to calorie reduction must be employed and artificial sweeteners alone will not do the trick. Simply put, “there’s no free lunch.”

In the final analysis, the reviewers conclude that while the short- and long-term safety of these products are established, we simply do not have solid evidence that they affect body weight, either by promoting overeating or by helping to shed pounds. Appetite and weight regulation are complex and more research is required to fully understand these issues.

Real food rules

Given the ambiguous conclusions of this review, what’s a dieter to do? Even dessert, full of fat and sugar, can be part of a healthy diet when consumed occasionally and in proper proportion. One of the most respected food experts of our time, Marion Nestle concludes, “You know my rule from What to Eat: never eat anything with anything artificial in it.” If this doesn’t work for you, consider the sage words of writer Michael Pollan: “Eat food. Not too much. Mostly plants.” If we all did this, we’d be a lot healthier.

(Am J Clin Nutr 2009;89:1–14; http://whattoeatbook.com/2008/02/10/the-diet-soda-puzzle; http://www.michaelpollan.com)

Suzanne Dixon, MPH, MS, RD

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